In the past, circumstances in the private health insurance were like a paradise for most of the patients. The private health insurance offered their mainly young, healthy and well paid customers an excellent comprehensive coverage for little money, while hardly any attention was paid to economical issues. Unfortunately, these times are gone. Today, private health insurance increasingly analyzes if a treatment will be covered at all and, first of all, to which extent. There are significant differences in refunding which can range from widespread generosity to denying anything though being aware of legal infringement. So you have to try having a treatment plan issued by the orthodontist and turning it in individually. Private health insurance always request the diagnostic documents of adults in order to let them assess by a judge put in charge by their side, but this procedure is also becoming more and more common for treatments of children. The assessors authorized by the private health insurance are indeed not neutral but have a contract with and work for the insurance – which shows in the assessments. The private insurances often not only deny the medical treatment need but even more regularly put into question the treatment fee, especially the so-called incremental factors and their justifications. These disputes unfortunately become increasingly stressful for both physicians and patients.
In the private insurance treatment fees can be many times the amount covered by the public health insurance according to the federal scale of fees GOZ (though this difference has evened more and more by additional private fees asked in the public health insurance sector during the last years). With the decreasing willingness of the private insurances to refund treatment costs, private insurance customers have to become acquainted to the fact that they have to pay for a certain part of the cost on their own. The treatment costs can range from 1,000 Euros for the straightening of two front teeth to much more than 10,000 Euros for a complex treatment of adult patients.